Evidence map›Paper›PMID 29372291›Full record

SynthesisIntensive care medicine2018

Effects of shorter versus longer storage time of transfused red blood cells in adult ICU patients: a systematic review with meta-analysis and Trial Sequential Analysis.

Sofie L Rygård, Andreas B Jonsson, Martin B Madsen, Anders Perner, Lars B Holst, Pär I Johansson, Jørn Wetterslev

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Intensive care medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
  4. Observational
  5. Article
  6. Article
  7. Review
  8. Article
  9. MicroRNA Dysregulation Associated with Red Blood Cell Storage.Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie · 2018
    Article
  10. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Sofie L RygårdDepartment of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Inge Lehmans Vej 5, Opg. 3, 3. sal, 4131, 2100, Copenhagen, Denmark. sofie.louise.rygaard@regionh.dk.
Andreas B JonssonDepartment of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Inge Lehmans Vej 5, Opg. 3, 3. sal, 4131, 2100, Copenhagen, Denmark.
Martin B MadsenDepartment of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Inge Lehmans Vej 5, Opg. 3, 3. sal, 4131, 2100, Copenhagen, Denmark.
Anders PernerDepartment of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Inge Lehmans Vej 5, Opg. 3, 3. sal, 4131, 2100, Copenhagen, Denmark.
Lars B HolstDepartment of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Inge Lehmans Vej 5, Opg. 3, 3. sal, 4131, 2100, Copenhagen, Denmark.
Pär I JohanssonDepartment of Transfusion Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Jørn WetterslevCopenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen, Denmark.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePatients in the intensive care unit (ICU) are often transfused with red blood cells (RBC). During storage, the RBCs and storage medium undergo changes, which may have clinical consequences. Several trials now have assessed these consequences, and we reviewed the present evidence on the effects of shorter versus longer storage time of transfused RBCs on outcomes in ICU patients.

methodsWe conducted a systematic review with meta-analyses and trial sequential analyses (TSA) of randomised clinical trials including adult ICU patients transfused with fresher versus older or standard issue blood.

resultsWe included seven trials with a total of 18,283 randomised ICU patients; two trials of 7504 patients were judged to have low risk of bias. We observed no effects of fresher versus older blood on death (relative risk 1.04, 95% confidence interval (CI) 0.97-1.11; 7349 patients; TSA-adjusted CI 0.93-1.15), adverse events (1.26, 0.76-2.09; 7332 patients; TSA-adjusted CI 0.16-9.87) or post-transfusion infections (1.07, 0.96-1.20; 7332 patients; TSA-adjusted CI 0.90-1.27). The results were unchanged by including trials with high risk of bias. TSA confirmed the results and the required information size was reached for mortality for a relative risk change of 20%.

conclusionsWe may be able to reject a clinically meaningful effect of RBC storage time on mortality in transfused adult ICU patients as our trial sequential analyses reject a 10% relative risk change in death when comparing fresher versus older blood for transfusion.

Indexed as

ErythrocytesErythrocyte TransfusionIntensive Care UnitsAdultCritical CareHumansRandomized Controlled Trials as TopicSpecimen HandlingTime FactorsBlood preservationBlood transfusionErythrocyte transfusionIntensive care unit and critical careStorage

Identifiers

PMID29372291

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.